Module 11: Birth Planning and Postnatal Care

Birth Planning

• Surrogacy birth plans are developed collaboratively by the surrogate and intended parents (IP(s)), often included in the surrogacy agreement.
• Essential issues in birth plans include preferred birth method, attendees at birth, infant care preferences, cord cell storage, feeding choices, and welfare decision-making.
• Healthcare staff should support and ensure reasonable requests are met without restricting the surrogate's or IP(s) wishes due to existing policies.
• In the absence of a birth plan, staff should help create one with the surrogate and the IP(s), noting the surrogate's consent for IP(s) involvement.
• A copy of the birth plan should be filed in hospital records and shared with the Head of Midwifery, alongside a treatment summary if applicable.
• Support should be extended for both the surrogate’s chosen birth partner and the IP(s) during the birth to encourage bonding and skin-to-skin contact.
• If an emergency arises requiring transfer to the operating theater, priority must be given to clinical care when deciding attendance.

Postnatal Care for Women

• WHO emphasizes the importance of understanding perspectives on maternal and newborn care to enhance postnatal experiences.
• Key aspects of postnatal care include monitoring postpartum recovery, emotional support, nutrition, and vital follow-up care six weeks post-delivery.
• Monitoring mother's well-being involves managing postpartum pain, identifying complications, and addressing emotional health concerns.
• Baby care includes tracking health metrics, promoting breastfeeding, and scheduling pediatric check-ups for growth monitoring.
• Support within the household facilitates recovery by sharing daily tasks and fostering a nurturing environment.
• Discussions around birth control post-delivery are crucial to prevent unplanned pregnancies, informing mothers about suitable contraceptive methods.

Postnatal Care for Surrogates

• Surrogates must prioritize rest, hydration, and a healthy diet for recovery post-delivery.
• Follow-up care is essential for healing and addressing any health-related concerns.
• Emotional support should be sought to navigate feelings post-birth, especially regarding potential bonding with the baby.
• Open communication with IP(s) about boundaries and involvement is key to emotional well-being post-delivery.
• Self-care and relaxation practices are essential for managing stress during recovery.
• Discharge information should include follow-up care details and should be communicated to relevant healthcare providers.
• Access to community midwives can help identify and support at-risk surrogates for postnatal depression in the weeks following birth.

Postnatal Care for Intended Parents

• Postnatal experience for IP(s) often differs significantly, as care typically shifts fully to them after birth.
• Clear agreements in the surrogacy contract regarding responsibilities, care, and discharge details foster understanding among all parties.
• Staff must ensure compliance with safeguarding policies to protect the child's welfare, addressing any concerns promptly.
• Postnatal accommodations should respect the privacy and preferences of both surrogates and IP(s), facilitating separate but accessible spaces.
• All parties should agree to the terms of care and custody in the surrogacy agreement for clarity and legal protection.
• Written consent from the surrogate is mandatory for the child's discharge with the IP(s). Transfers should occur within hospital premises without forcing parties to exit.
• Staff should consider social worker involvement only if there are concerns about the well-being of any involved parties.